| NPI | 1477792406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 54087) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125-050855) |
| Enumeration Date | 2009-02-15 |
| Last Update Date | 2024-04-16 |